Contrast medium volume to creatinine clearance ratio: A predictor of contrast-induced nephropathy in the first 72 hours following percutaneous coronary intervention

Objectives: To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast‐induced nephropathy (CIN) (i.e., within 48–72 hr) and to determine a relatively safe V/CrCl cut‐off value to avoid CIN in patients following percutaneous coron...

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Published inCatheterization and cardiovascular interventions Vol. 79; no. 1; pp. 70 - 75
Main Authors Tan, Ning, Liu, Yong, Zhou, Ying-Ling, He, Peng-Cheng, Yang, Jun-Qing, Luo, Jian-Fang, Chen, Ji-Yan
Format Journal Article
LanguageEnglish
Published Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.01.2012
Subjects
Adult
Aged
Angioplasty, Balloon, Coronary
Biomarkers - blood
China
Contrast Media - adverse effects
Contrast Media - pharmacokinetics
contrast medium
contrast-induced nephropathy
Creatinine - blood
creatinine clearance
diabetes
Female
Humans
Kidney Diseases - blood
Kidney Diseases - chemically induced
Kidney Diseases - diagnosis
Kidney Diseases - prevention & control
Logistic Models
Male
Middle Aged
Multivariate Analysis
percutaneous coronary intervention
Predictive Value of Tests
Prospective Studies
Radiography, Interventional - adverse effects
Risk Assessment
Risk Factors
ROC Curve
Sensitivity and Specificity
Time Factors
Treatment Outcome
Up-Regulation
China
Online AccessGet full text

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Abstract Objectives: To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast‐induced nephropathy (CIN) (i.e., within 48–72 hr) and to determine a relatively safe V/CrCl cut‐off value to avoid CIN in patients following percutaneous coronary intervention (PCI). Background: The V/CrCl ratio is a pharmacokinetic risk factor for an early abnormal increase in serum creatinine (i.e., within 24 hr) after PCI. Methods: V/CrCl ratios were obtained from 1,140 consecutive consenting patients after unselective PCI. Receiver‐operator characteristic (ROC) curves were used to identify the optimal sensitivity for the observed range of V/CrCl. The predictive value of V/CrCl for the risk of CIN was assessed using multivariate logistic regression. Results: Fifty‐five (4.8%) patients out of 1,140 developed CIN. There was a significant association between higher V/CrCl ratio values and risk of CIN in the overall population: 1.4%, 1.4%, 5.7%, and 10.9% for quartile 1 (Q1) of the V/CrCl value (<1.56, n = 283), Q2 (1.56–2.27, n = 289), Q3 (2.28–3.42, n = 282), and Q4 (>3.42, n = 285) of contrast, respectively (P < 0.001). ROC curve analysis indicated that a V/CrCl ratio of 2.62 was a fair discriminator for CIN (C‐statistic 0.73). After adjusting for other known predictors of CIN, V/CrCl ratios > 2.62 remained significantly associated with CIN (odds ratio: 2.20; 95% confidence interval: 1.00–4.81, P < 0.05). Conclusion: A V/CrCl ratio > 2.62 was a significant and independent predictor of CIN after PCI in unselected patients. © 2011 Wiley Periodicals, Inc
AbstractList To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast-induced nephropathy (CIN) (i.e., within 48-72 hr) and to determine a relatively safe V/CrCl cut-off value to avoid CIN in patients following percutaneous coronary intervention (PCI).OBJECTIVESTo investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast-induced nephropathy (CIN) (i.e., within 48-72 hr) and to determine a relatively safe V/CrCl cut-off value to avoid CIN in patients following percutaneous coronary intervention (PCI).The V/CrCl ratio is a pharmacokinetic risk factor for an early abnormal increase in serum creatinine (i.e., within 24 hr) after PCI.BACKGROUNDThe V/CrCl ratio is a pharmacokinetic risk factor for an early abnormal increase in serum creatinine (i.e., within 24 hr) after PCI.V/CrCl ratios were obtained from 1,140 consecutive consenting patients after unselective PCI. Receiver-operator characteristic (ROC) curves were used to identify the optimal sensitivity for the observed range of V/CrCl. The predictive value of V/CrCl for the risk of CIN was assessed using multivariate logistic regression.METHODSV/CrCl ratios were obtained from 1,140 consecutive consenting patients after unselective PCI. Receiver-operator characteristic (ROC) curves were used to identify the optimal sensitivity for the observed range of V/CrCl. The predictive value of V/CrCl for the risk of CIN was assessed using multivariate logistic regression.Fifty-five (4.8%) patients out of 1,140 developed CIN. There was a significant association between higher V/CrCl ratio values and risk of CIN in the overall population: 1.4%, 1.4%, 5.7%, and 10.9% for quartile 1 (Q1) of the V/CrCl value (<1.56, n = 283), Q2 (1.56-2.27, n = 289), Q3 (2.28-3.42, n = 282), and Q4 (>3.42, n = 285) of contrast, respectively (P < 0.001). ROC curve analysis indicated that a V/CrCl ratio of 2.62 was a fair discriminator for CIN (C-statistic 0.73). After adjusting for other known predictors of CIN, V/CrCl ratios > 2.62 remained significantly associated with CIN (odds ratio: 2.20; 95% confidence interval: 1.00-4.81, P < 0.05).RESULTSFifty-five (4.8%) patients out of 1,140 developed CIN. There was a significant association between higher V/CrCl ratio values and risk of CIN in the overall population: 1.4%, 1.4%, 5.7%, and 10.9% for quartile 1 (Q1) of the V/CrCl value (<1.56, n = 283), Q2 (1.56-2.27, n = 289), Q3 (2.28-3.42, n = 282), and Q4 (>3.42, n = 285) of contrast, respectively (P < 0.001). ROC curve analysis indicated that a V/CrCl ratio of 2.62 was a fair discriminator for CIN (C-statistic 0.73). After adjusting for other known predictors of CIN, V/CrCl ratios > 2.62 remained significantly associated with CIN (odds ratio: 2.20; 95% confidence interval: 1.00-4.81, P < 0.05).A V/CrCl ratio > 2.62 was a significant and independent predictor of CIN after PCI in unselected patients.CONCLUSIONA V/CrCl ratio > 2.62 was a significant and independent predictor of CIN after PCI in unselected patients.
To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast-induced nephropathy (CIN) (i.e., within 48-72 hr) and to determine a relatively safe V/CrCl cut-off value to avoid CIN in patients following percutaneous coronary intervention (PCI). The V/CrCl ratio is a pharmacokinetic risk factor for an early abnormal increase in serum creatinine (i.e., within 24 hr) after PCI. V/CrCl ratios were obtained from 1,140 consecutive consenting patients after unselective PCI. Receiver-operator characteristic (ROC) curves were used to identify the optimal sensitivity for the observed range of V/CrCl. The predictive value of V/CrCl for the risk of CIN was assessed using multivariate logistic regression. Fifty-five (4.8%) patients out of 1,140 developed CIN. There was a significant association between higher V/CrCl ratio values and risk of CIN in the overall population: 1.4%, 1.4%, 5.7%, and 10.9% for quartile 1 (Q1) of the V/CrCl value (<1.56, n = 283), Q2 (1.56-2.27, n = 289), Q3 (2.28-3.42, n = 282), and Q4 (>3.42, n = 285) of contrast, respectively (P < 0.001). ROC curve analysis indicated that a V/CrCl ratio of 2.62 was a fair discriminator for CIN (C-statistic 0.73). After adjusting for other known predictors of CIN, V/CrCl ratios > 2.62 remained significantly associated with CIN (odds ratio: 2.20; 95% confidence interval: 1.00-4.81, P < 0.05). A V/CrCl ratio > 2.62 was a significant and independent predictor of CIN after PCI in unselected patients.
Objectives : To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast‐induced nephropathy (CIN) (i.e., within 48–72 hr) and to determine a relatively safe V/CrCl cut‐off value to avoid CIN in patients following percutaneous coronary intervention (PCI). Background : The V/CrCl ratio is a pharmacokinetic risk factor for an early abnormal increase in serum creatinine (i.e., within 24 hr) after PCI. Methods : V/CrCl ratios were obtained from 1,140 consecutive consenting patients after unselective PCI. Receiver‐operator characteristic (ROC) curves were used to identify the optimal sensitivity for the observed range of V/CrCl. The predictive value of V/CrCl for the risk of CIN was assessed using multivariate logistic regression. Results : Fifty‐five (4.8%) patients out of 1,140 developed CIN. There was a significant association between higher V/CrCl ratio values and risk of CIN in the overall population: 1.4%, 1.4%, 5.7%, and 10.9% for quartile 1 (Q1) of the V/CrCl value (<1.56, n = 283), Q2 (1.56–2.27, n = 289), Q3 (2.28–3.42, n = 282), and Q4 (>3.42, n = 285) of contrast, respectively ( P < 0.001). ROC curve analysis indicated that a V/CrCl ratio of 2.62 was a fair discriminator for CIN (C‐statistic 0.73). After adjusting for other known predictors of CIN, V/CrCl ratios > 2.62 remained significantly associated with CIN (odds ratio: 2.20; 95% confidence interval: 1.00–4.81, P < 0.05). Conclusion : A V/CrCl ratio > 2.62 was a significant and independent predictor of CIN after PCI in unselected patients. © 2011 Wiley Periodicals, Inc
Objectives: To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast‐induced nephropathy (CIN) (i.e., within 48–72 hr) and to determine a relatively safe V/CrCl cut‐off value to avoid CIN in patients following percutaneous coronary intervention (PCI). Background: The V/CrCl ratio is a pharmacokinetic risk factor for an early abnormal increase in serum creatinine (i.e., within 24 hr) after PCI. Methods: V/CrCl ratios were obtained from 1,140 consecutive consenting patients after unselective PCI. Receiver‐operator characteristic (ROC) curves were used to identify the optimal sensitivity for the observed range of V/CrCl. The predictive value of V/CrCl for the risk of CIN was assessed using multivariate logistic regression. Results: Fifty‐five (4.8%) patients out of 1,140 developed CIN. There was a significant association between higher V/CrCl ratio values and risk of CIN in the overall population: 1.4%, 1.4%, 5.7%, and 10.9% for quartile 1 (Q1) of the V/CrCl value (<1.56, n = 283), Q2 (1.56–2.27, n = 289), Q3 (2.28–3.42, n = 282), and Q4 (>3.42, n = 285) of contrast, respectively (P < 0.001). ROC curve analysis indicated that a V/CrCl ratio of 2.62 was a fair discriminator for CIN (C‐statistic 0.73). After adjusting for other known predictors of CIN, V/CrCl ratios > 2.62 remained significantly associated with CIN (odds ratio: 2.20; 95% confidence interval: 1.00–4.81, P < 0.05). Conclusion: A V/CrCl ratio > 2.62 was a significant and independent predictor of CIN after PCI in unselected patients. © 2011 Wiley Periodicals, Inc
Author Luo, Jian-Fang
Tan, Ning
He, Peng-Cheng
Liu, Yong
Yang, Jun-Qing
Zhou, Ying-Ling
Chen, Ji-Yan
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Bartholomex BA, Harjai KJ, Dukkipati S, et al. Impact of nephropathy after percutaneous coronary intervention and a method of risk stratification. Am J Cardiol 2004; 93: 1515-1519.
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Freeman RV, O'Donnell M, Share D, et al. Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose. Am J Cardiol 2002; 90: 1068-1073.
Bai X, Han L, Liu J, Zhang W, Zhou H, Dong S, Sun Y, Chen X. The relationship between age-related kidney dysfunction and Framingham risk score in healthy people in China. Curr Aging Sci 2010; 3: 188-197.
Marenzi G, Lauri G, Assanelli E, et al. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol 2004; 44: 1780-1785.
Gleeson TG, Bulugahapitiya S. Contrast-induced nephropathy. Am J Roentgenol 2004; 183: 1673-1689.
McCullough PA, Adam A, Becker CR, et al. Risk prediction of contrast-induced nephropathy. Am J Cardiol 2006; 98 ( Suppl): 27K-36K.
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Snippet Objectives: To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast‐induced...
Objectives : To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast‐induced...
To investigate the predictive value of the contrast media volume to creatinine clearance (V/CrCl) ratio for the risk of contrast-induced nephropathy (CIN)...
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StartPage 70
SubjectTerms Adult
Aged
Angioplasty, Balloon, Coronary
Biomarkers - blood
China
Contrast Media - adverse effects
Contrast Media - pharmacokinetics
contrast medium
contrast-induced nephropathy
Creatinine - blood
creatinine clearance
diabetes
Female
Humans
Kidney Diseases - blood
Kidney Diseases - chemically induced
Kidney Diseases - diagnosis
Kidney Diseases - prevention & control
Logistic Models
Male
Middle Aged
Multivariate Analysis
percutaneous coronary intervention
Predictive Value of Tests
Prospective Studies
Radiography, Interventional - adverse effects
Risk Assessment
Risk Factors
ROC Curve
Sensitivity and Specificity
Time Factors
Treatment Outcome
Up-Regulation
Title Contrast medium volume to creatinine clearance ratio: A predictor of contrast-induced nephropathy in the first 72 hours following percutaneous coronary intervention
URI https://api.istex.fr/ark:/67375/WNG-79L8T543-6/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fccd.23048
https://www.ncbi.nlm.nih.gov/pubmed/21990069
https://www.proquest.com/docview/912642113
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